You need to get calories from somewhere, should it be from carbohydrate or fat?

Monday, September 14, 2009

Sweden and diabetes again: Salty beer in Kiwiland

If you go to the homepage of the Lancet and search on Mann and Nye you will get this preview of their comment on the woeful state of diabetes management in Sweden. If you want to spend $31.50 (which I don't) you can obviously read the full text. Here's the preview text via the Lancet homepage, there's no abstract on PubMed:

"There will be much greater interest than is usually the case in the outcome of a review of the scientific evidence for dietary recommendations for patients with diabetes commissioned by the National Board of Health and Welfare in Sweden. This review is not yet finalised and thus not yet published. The appearance of fad diets offering near miraculous health outcomes invariably attracts hordes of adherents hoping for a magic bullet, the books describing them often becoming bestsellers. The ultra-low-carbohydrate Atkins diet was no exception, spawning specialist products, supermarkets, and restaurants worldwide"

If you want the basic flavour of the full text, while keeping your small change, you can go to Medical News Today's website. I've kept a copy of the text for when the link goes down but for now here is the biggest giggle in the article:

"A group of experts which is a branch of the Board was scheduled to publish a report on nutritional recommendations for people with diabetes. However two of the experts on the panel were withdrawn by the newly appointed Director-General. He considered that their links to the food industry via the Swedish Nutrition Foundation might represent a conflict of interest. The Foundation receives food industry funding. It also provides independent advice to the industry through expert scientists. The two scientists involved (Bengt Vessby and Nils-Georg Asp) are internationally respected. Their dismissal caused outrage in the rest of the Board and the scientific community."

I think the journalist is using the term "scientist" very loosely here.

Personally, if I were either Mann or Nye I'd be thinking what I might do to earn my living if I got the boot in NewZealand in the same way as did Vessby and Asp in Sweden. As always, lavatory attendant would be my preferred re training option for them.

Less crying in their beer would be a nice too. But then, if I was as wrong as they are, I'd be crying in my beer too!

8 comments:

"It is also ironic that this debate should have occurred in a country which helped to pioneer cardiac rehabilitation and preventive cardiology, and one of the few to report a decline in the rates of childhood obesity."

and this:

An anonymous letter, quoting Dahlqvist's blogs, has been sent to all schools, preschools, and day-care centres in the country, advocating this dietary approach to 'save our children's brains'. The authors explain: "Despite the National Food Administration of Sweden having published a list of 72 articles which suggest that high fat diets are detrimental compared with eight articles suggesting that they are not, enthusiasm for high-fat diets persists. One of Dahlqvist's popular books on the subject of high-fat diets has been number one on the non-fiction bestseller list in Sweden."

Well yes, especially once you read Dr Garemo's PhD papers where the observational findings from middle class Swedish children is that saturated fat is inversely associated with obesity and sucrose intake is directly associated with both obesity and insulin resistance... Didn't know Dahlquvist had published in the mainstream book market... Could one person single handedly save a nation's children?

The great thing about Sweden is unlike certain other countries (cough..Finland), you can still get the old fashioned high fat products. Gammaldags milk in Sweden is completely unskimmed and here are tons of other products that are full fat.

Swedes aren't afraid of fat. But they are gorgeous people who don't have much fat on them. When I moved back to the US after living there awhile, one of the hardest things was getting used to how darn fat my fellow americans are.

Thanks Amy, but it's an opinion piece by one entrenched nutritionalist plus someone who is more widely based (more senior?) and it's unlikely to have anything other than disinformation in it... The shock of having two "experts" removed from a panel due to being of dubious partiality must be worrying a lot of nutrition departments.

Even Yudkin accepted large amounts of industry money on behalf of Kings College. He was all the more appreciative as he knew his research was not to their liking. Things were different back in the 60s!

Is it reversing? Obesity seems to have stabilised in the USA too. I'm suspicious that there is a certain percentage of the population who respond to carbohydrate with obesity and that obesity can only go so far before weight stabilisation happens and diabetes follows, ie when weight gain is impossible it cannot act as a buffer to protect against hypercaloric intake secondary to carb intake during insulin resistance.... For people in this situation low carb is the only sustainable option (starvation to lower insulin has limited long term application!).

About Me

I am Petro Dobromylskyj, always known as Peter. I'm a vet, trained at the RVC, London University. I was fortunate enough to intercalate a BSc degree in physiology in to my veterinary degree. I was even more fortunate to study under Patrick Wall at UCH, who set me on course to become a veterinary anaesthetist, mostly working on acute pain control. That led to the Certificate then Diploma in Veterinary Anaesthesia and enough publications to allow me to enter the European College of Veterinary Anaesthesia and Analgesia as a de facto founding member. Anaesthesia teaches you a lot. Basic science is combined with the occasional need to act rapidly. Wrong decisions can reward you with catastrophe in seconds. Thinking is mandatory.
I stumbled on to nutrition completely by accident. Once you have been taught to think, it's hard to stop. I think about lots of things. These are some of them.

Organisation (or lack of it)!

The "labels" function on this blog has been used to function as an index and I've tended to group similar subjects together by using labels starting with identical text. If they're numbered within a similar label, start with (1). The archive is predominantly to show the posts I've put up in the last month, if people want to keep track of recent goings on. I might change it to the previous week if I ever get to time to put up enough posts in a week to justify it. That seems to be the best I can do within the limits of this blogging software!